Hospital-acquired pneumonia (non COVID-19)

The all-cause mortality for HAP is 30% to 70%, while the attributable mortality is approximately 10%. Many people with HAP die of their underlying cause. Increased mortality has been associated with patients who have HAP due to Pseudomonas aeruginosa or Acinetobacter species, received an antimicrobial that did not cover the offending pathogen, and had medical instead of surgical illness.[7]Heyland DK, Cook DJ, Griffith L, et al. The attributable morbidity and mortality of ventilator-associated pneumonia in the critically ill patient. Am J Respir Crit Care Med. 1999 Apr;159(4 Pt 1):1249-56. http://www.atsjournals.org/doi/full/10.1164/ajrccm.159.4.9807050#.UkWV5tKsjTo http://www.ncbi.nlm.nih.gov/pubmed/10194173?tool=bestpractice.com The likelihood of acquiring ventilator-associated pneumonia (VAP) is highest early on; most patients acquire pneumonia within 10 days of being intubated.

Late outcome

It is not uncommon for patients with HAP, who typically have multiple comorbidities or severe trauma, to have prolonged respiratory failure and, hence, take weeks or even months to be weaned off the ventilator. Patients will recover from HAP and still require ventilation, so the duration of ventilation does not correspond to the duration of HAP. Antimicrobials may be discontinued after just 7 days if the patient is stable and neither Pseudomonas nor Acinetobacter caused the HAP.[106]Chastre J, Wolff M, Fagon JY, et al; PneumA Trial Group. Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial. JAMA. 2003 Nov 19;290(19):2588-98. http://jama.jamanetwork.com/article.aspx?articleid=197644 http://www.ncbi.nlm.nih.gov/pubmed/14625336?tool=bestpractice.com A shorter duration of antimicrobials, such as 7 days, may prevent antimicrobial resistance.